The next round of hospital fun is about to begin. I’ll be going in to Zale Lipshy hospital on Wednesday for some pre-surgery prodding, scanning and interrogation with surgery to happen on Thursday (18th).
Since my last update, I’ve had another MRI and talked to a specialist at UT Southwestern who recommended another surgery ‘soon’ to finish the work that was begun at Baylor. They’ll go in and hopefully clean out all the cholesteatoma, remove my ossicles and send me home on the same day.
The scan (before my last surgery) below shows my mastoid and middle ear filled with ‘stuff.’ They can’t really tell what’s fluid and what’s cholesteatoma from the scans but you can clearly see that it doesn’t belong. Look at the lack of symmetry on the left and right sides of my head in the left scan. What should be empty space (no, not the middle of the scan) in the mastoid as seen on the left, is filled with something what looks like a little brain in the scan. I wish it were. I could use some extra brain.
The word ‘hopefully’ is up there because there’s a possibility I’ll also need a craniotomy (you don’t really want to look that up on Wikipedia) because of a hole between the middle ear and brain. If you look closely you can see a sign of that on the right side of the following scan.
The scans aren’t exactly symmetrical but see that grey area on the right, leading from the brain to the middle ear with no bright white line separating the two? That’s an area where there isn’t bone where there should be.
In the first surgery back at Baylor the doctor could actually see the dura (brain lining). If the hole is small enough and there’s no brain coming down into the middle ear (an encephalocele) then they’ll be able to repair it from the lower side.
Do NOT do a search on encephalocele, you will not sleep for days. The pictures you find will typically be about the congenital form which is not what I might have. Just don’t go looking.
In the worst case, they’ll have to do a crainotomy and go in from the top. Yep, they’ll move my brain (but fortunately not remove my brain) and repair the hole from above.
Hopefully I’ll only need the basic surgery and go home the same day with a few days of recovery. In the alternate case I’ll be in the hospital over the weekend and recovering for another week or two.
In either case I won’t be able to hear any better out of my left ear than I do now (which is almost not at all) but in the next year they’ll go back in to make sure the cholesteatoma hasn’t regrown and also do reconstruction on my middle ear to restore some of my hearing.